This is the full account of my injury survival story:
I am one of the lucky few that has made a full recovery from a near career ending shoulder injury. It took 2 years of intense, daily physiotherapy, economic hardship, depression, loss of work and a whole lot of pain, but I made it. I also learned a lot in the process and I am now determined to help others avoid the problems that I’ve had. Here is my story:
In the fall of 2005 I was living in Sweden and working full time in the Malmö Opera Orchestra, when I started experiencing a slight, but relentless pain on the front of my left shoulder when playing. I brushed it of as a result of practicing a lot, and not having a proper setup. I tried countless shoulder rests and chin rests (and by this I mean practically everything on the market and a handful homemade varieties), but nothing helped.
In march 2006 the final drop was the combination of 7 hour rehearsal days and Mozart’s Marriage of Figaro – a notoriously physically challenging opera. On opening night I could barely lift the violin up to play for the pain. The next day I called in sick for the first time in my professional life.
The doctor I went to see the next day informed me that it was just inflammation of the biceps tendon and would get better with rest, so I took 6 weeks off – risky business for a freelancer on a contract, and worst of all; it didn’t help. When I returned to work, so did the pain. I revisited the doctor to get referred to a specialist, which he promptly refused, claiming that he knew full well what was wrong, and that I just needed a longer break. I switched to another doctor, who over the summer pumped my shoulder joint full of cortisone and got me on the 5 month waiting list for a specialist. I also took 3 months off and when the opera graciously extended my contract upon my insurances that I was fine, I resumed work. I also started physiotherapy and was given exercises that I now know only aggravated the problem.
Less than 2 months later, when the effect of the cortisone wore off, the pain came back and this time with a vengeance. Now it was not just the shoulder, but my entire upper arm. I couldn’t do anything with the arm away from the body – turning page gave me excruciating electric shock like pain in the arm. “Luckily” I had by now made it to the top of the waiting list for the specialist. Unfortunately, as I would learn over the coming months, he didn’t really care much. He relied solely on an MR scan that showed I had a little wear and tear in the upper shoulder joint, the so called AC-joint. He never did a clinical exam, in fact he never even asked me exactly where the pain was. And so, based only on the scan, he informed me that I needed and operation and also that the waiting list for said operation was about 7 months. This made me (apart from desperate and freaked out) a little suspicious and thanks to the help of my doctor sister, I discovered that one of Europe’s finest orthopedic surgeons and shoulder specialist had opened a private clinic in Copenhagen. This man, Klaus Bak, a year after the first signs of pain, finally gave me the correct diagnosis and thus saved me from a potentially career ending operation.
As it turned out, the first doctor was right in his assessment of inflammation of the biceps tendon. What he failed to diagnose was the underlying cause: A massive shoulder blade dysfunction that was pushing the joint out of it’s socket and upwards into the top of the shoulder blade. Thus was not only my biceps tendon under constant stress, but the armbone was grinding up into the soft tissue under the top of the shoulder blade (impingement) – trust me, this is very painful. He also informed me that no operation could help me – only intense physiotherapy would help. So that’s what I did, under the watchful eye of physiotherapist and shoulder specialist John Verner.
For the next 18 months I only played 5-10 minutes a week, and even that was painful – also mentally, as it was a painful reminder of the one thing I wanted to do the most, but couldn’t. Even going to concerts turned into painful memories of a life and a dream I could no longer live, and eventually I stopped doing it.
For the first 6 months I felt no progress at all. Everything was painful; tying my shoes, doing the dishes and I developed complex one-armed ways of putting on shirts and jackets to avoid provoking the pain. When my contract expired at he end of the year, and I was informed by the Swedish government that I would also loose my sickness benefit, I started sinking into a severe depression, but even in the midst of a whole lot of staring at the wall and feeling sorry for myself, I never stopped doing my exercises, and ultimately that saved me. I began studying anatomy to understand what was wrong, and it became clear to me that sooner or later, the exercises HAD to work, so I muddled through. I ended up having 2 more cortisone injections, but this time they were effective, because they were administered by the orthopedic surgeon working closely with my physiotherapist. It knocked down the inflammation in the joint long enough for me to do the exercises that brough stability back to the joint. I was under constant pressure from the government to give up music and “get a job where you only need one arm”. They completely ignored my doctors statement that even light office work could permanently ruin my shoulder – when I wasn’t doing my exercises I had to keep it at complete rest. In the end I survived on unemployment benefit thanks to an understanding case worker.
About a year after I put the violin on the shelf, my progress was so steady that I started to believe in a return to playing, and I applied for a residency at the Banff Centre in Canada – and I was accepted! This saved my life. I have never before been in such a supportive, creative and inspired setting, but more important, it gave me the time to rebuild my playing from scratch, applying all I had learned about anatomy and posture. I worked closely with the physiotherapist on campus, the excellent Hugh Simson, and together we discovered a lot about what constitutes healthy violin playing and the bad habits that put me on the wrong track years ago. Reinventing your playing after an 18 month break and correcting 20 years of bad habits, is a time consuming and delicate process. Had it not been for Banff, I would never had the time or space to do this the right way, and I am confident that without this residency I would not have made a successful comeback!
I am now back to a normal practicing schedule for a professional – in fact I can play longer than I could before because of the strength I have build (and maintain everyday) during the physiotherapy. Because I was given the right diagnosis and treatment so late, I have some scar tissue around the biceps tendon, but it never bothers me while playing. In the end I emerged a better player and a stronger person from all this, but having go through what I went through is not something I would wish on my worst enemy. This is why I am so determined to continue to educate myself further in these matters and to push for more medical research and have that research be conveyed to us, the musicians, in a language that we can understand. This is also what I try to accomplish with my “Anatomy and Injury Prevention for Musicians” lecture. You can read more about it here.